![]() ![]() Past exposure of the pacient to tuberculosis (2 years ago) and positive tuberculin skin test have established the etiology. After glucocorticoids replacement,the electrolytes imbalances and his symptoms have improved significantly. Biological test identified hyponatremia (129 mmol/l), hyperkalemia (5.43 mmol/l), high ACTH (>1250 pg/ml), low serum cortisol level (2.1 ug/dl), suggestive values for primary adrenal insufficiency. Examination showed remarkable hyperpigmentation of the skin, oral mucosa and nails. In some cases, the background of tuberculosis and hyperpigmentation, which is one of the most common clinical manifestation in Addisons disease, allow early recognition.Ĭase 1: An 43-year-old male patient without a significant past medical history was investigated for a sudden onset of: nausea, vomiting, inappetence, and azotate retention. Adrenal tuberculosis is difficult to diagnose, the classic presentation with non specific symptoms delay the diagnosis. The two most common cause of primary adrenal insufficiency are autoimmune adrenalitis and adrenal tuberculosis, which is still the primary cause of primary adrenal insufficiency (PAI) in developing countries. ![]() Introduction: Addisons disease is a rare disorder, described mainly in isolated cases. ![]()
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